Individual
FRED HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, LMFT
Contact information
Practice address
1225 N STATE ST, MAW SUITE 210, JACKSON, MS 39202-2064
(601) 973-1697
(601) 974-6260
Mailing address
1155 BRIARWOOD DR, JACKSON, MS 39211-4204
(601) 955-0649
(601) 974-6260
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2058298
AETNA PROVIDER NUMBER
MS
Enumeration date
04/16/2007
Last updated
09/11/2025
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